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The effects of central arterial pressure and autonomic dysfunction on elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in men with diabetes

Artery Research volume 2, pages 60–66 (2008)Cite this article

Summary

Background

In diabetes, left ventricular dysfunction independent of coronary disease is common and is associated with elevations in NT-proBNP. Our aims were to determine the relative importance of central aortic pressure, cardiovascular autonomic function and arterial stiffness as predictors of elevated NT-proBNP.

Methods

Fifty males with diabetes mellitus and 21 males with IGTwere studied. Arterial stiffness and wave reflections were assessed by measuring aortic and brachial pulse wave velocity (PWV) and augmentation index (AIX). Cardiovascular autonomic function was assessed by measurements of heart rate variability following standard manoeuvres.

Results

Comparing diabetes versus IGT subjects (mean ± SD), both aortic PWV (9.7 ± 2.4 versus 8.2 ± 1.4 m/s, p < 0.01) and cardiovascular autonomic dysfunction (autonomic score 2.3 ± 1.3 versus 1.6 ± 1.0, p < 0.01) were greater in diabetes subjects. NT-proBNP levels correlated with central and brachial systolic pressure (r = 0.74, p < 0.0001 and r = 0.66, p < 0.0001, respectively), aortic PWV (r = 0.43, p < 0.01), AIX (r = 0.55, p < 0.0001), and autonomic function (r = 0.37, p < 0.01). Multiple regression analysis amongst diabetic subjects showed central systolic blood pressure to be the strongest predictor of NT-proBNP concentrations.

Conclusions

Elevated central arterial pressure is a strong predictor of NT-proBNP concentrations in diabetic men without clinically apparent left ventricular dysfunction. This is indicative of the key influence of unfavourable large artery haemodynamics on the development of left ventricular dysfunction in diabetes.

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Authors and Affiliations

  1. Department of Medicine, Torbay Hospital, TQ2 7AA, Devon, UK

    S. Bunce, A. Stride, C. Matthews & J. C. Smith

  2. School of Mathematics and Statistics, University of Plymouth, PL4 8AA, UK

    S. Shaw

  3. Department of Diabetes & Endocrinology, Torbay Hospital, Lawes Bridge, TQ2 7AA, Torquay, UK

    J. C. Smith

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  1. S. Bunce
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  2. A. Stride
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  3. C. Matthews
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  4. S. Shaw
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Correspondence to J. C. Smith.

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This is an open access article distributed under the CC BY-NC license. https://doi.org/creativecommons.org/licenses/by/4.0/

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Bunce, S., Stride, A., Matthews, C. et al. The effects of central arterial pressure and autonomic dysfunction on elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in men with diabetes. Artery Res 2, 60–66 (2008). https://doi.org/10.1016/j.artres.2008.03.002

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  • DOI: https://doi.org/10.1016/j.artres.2008.03.002

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Artery Research

ISSN: 1876-4401

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